Is Bowel Leakage A Sign Of Cancer?

Bowel leakage, or fecal incontinence, can be embarrassing. Many people experience a loss of control from time to time, especially when dealing with a stomach bug. However, if you have persistent or recurring bowel leakage, you may wonder what’s causing it and if it’s a sign of cancer. 

Many conditions can cause bowel leakage, and most of them are treatable, but if you experience bowel leakage that doesn’t seem to be connected to a temporary stomach illness or something you ate, you should see a doctor, as it can be a sign of cancer and other serious illnesses. 

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What is bowel leakage?

Bowel leakage, or fecal incontinence, is characterized by difficulty controlling the release of fecal matter. A medical professional may describe the condition as the involuntary release of solid or liquid feces. You may have bowel leakage if you experience:

  • Urge incontinence, where you know you need to defecate but can’t make it to the toilet in time

  • Passive incontinence, where you pass stool and are unaware

Fecal incontinence is not uncommon and likely underreported. Minor illnesses, such as diarrhea from food poisoning, can lead to incontinence that typically resolves within a few hours to a couple of weeks. However, fecal incontinence may be cause for concern if it’s long-lasting or happens frequently.

While leakage is the primary symptom of fecal incontinence, it may be accompanied by diarrhea, constipation, increased gas, and bloating.

Bowel leakage can range in severity. Some people may experience occasional leakage while passing gas, while others may lose control completely.

Causes of bowel leakage

Bowel leakage can happen occasionally or often, and the frequency can help you and your doctor pin down the cause. Some people experience temporary leakage when they eat something that doesn’t agree with them or when they catch a stomach bug. For others, leakage is a long-term or recurring issue. 

Causes of lasting bowel leakage

Numerous factors can trigger long-term bowel leakage, including: 

  • Conditions associated with structural abnormalities in the muscles, nerves, tissue, or other structures, including inflammatory bowel disease, previous injury or surgery (obstetrical injury or hemorrhoidectomy, for example), rectal prolapse, spinal cord injuries, and multiple sclerosis.

  • Conditions associated with functional abnormalities, including diabetes mellitus and irritable bowel syndrome. 

  • Factors affecting stool characteristics include infections, certain medications, irritants (such as laxatives), and fecal impaction.

  • Other factors and conditions include advancing age, dementia, antidepressant use, caffeine, and food intolerances.

While it’s not among the most common causes, research indicates there are connections between bowel leakage and certain types of cancer.¹

Relationships between bowel leakage and cancer

Fortunately, most cases of bowel leakage aren’t caused by cancer. However, there’s evidence of relationships between the two. 

In their study of over 16,000 people across 20 years, one team of researchers found that bowel leakage was a marker within the year of developing incontinence for colorectal cancer, other types of gastrointestinal cancers, and lymphoma.

However, among people with bowel leakage, the risk of developing cancer was still low, and the initial increase in risk may have been due to increased diagnostic efforts. 

Compared to those without bowel incontinence, those with the condition were more likely to be diagnosed with one of the above-mentioned types of cancer within one year. Less commonly, study participants with bowel leakage went on to develop other types of cancer, including larynx, lung, and kidney cancer.

The researchers noted that this finding might be partly linked to shared risk factors, including smoking and obesity, which increase a person’s risk for cancer and bowel leakage. 

Signs your bowel leakage may be caused by cancer

All the symptoms of cancer can also indicate other, less serious conditions. However, people with cancer commonly experience certain symptoms.

Signs of colorectal cancer

Colorectal cancer often starts without symptoms, so screening is vital, but people with colorectal cancer may experience:

  • Blood in or on the stool

  • Changes in bowel habits

  • Diarrhea

  • Constipation

  • A feeling that the bowel is not fully emptying

  • Abdominal pain, aches, or cramps

  • Unexplained weight loss

Signs of other gastrointestinal cancers

Gastrointestinal cancers can affect the esophagus, liver, pancreas, and many other parts of the gastrointestinal system. The symptoms will depend on which part of the body is affected but may include:

  • Difficulty swallowing

  • Heartburn or indigestion

  • Abdominal pain or swelling

  • Loss of appetite

  • Vomiting blood or blood in the stool

  • Weakness and fatigue

  • Unexplained weight loss

  • Yellowing of the eyes and skin

Signs of lymphoma

Lymphoma is a cancer that starts in the lymph system, which consists of organs and tissues that produce, store, and transport infection-fighting white blood cells. Symptoms may include:

  • Swollen lymph nodes

  • Fever

  • Fatigue

  • Night sweats

  • Unexplained weight loss

Risk factors for cancer

Bowel leakage may be more concerning for people with a higher risk of developing cancer. While the presence of risk factors doesn’t necessarily mean a person’s bowel incontinence indicates cancer, people facing an increased risk should remain especially vigilant in monitoring their symptoms and seeing a doctor to rule out cancer. 

Risk factors for colorectal cancer

About 5% of people with colorectal cancer have gene mutations passed down through families, most commonly Lynch syndrome or familial adenomatous polyposis. In most cases, a person who develops colorectal cancer will have no family history of the condition. But as many as one in three people diagnosed have a family member with colorectal cancer.²

If you have a family history of colorectal cancer and you experience bowel incontinence, seek a diagnosis from your doctor. While it’s unlikely your bowel leakage is caused by cancer, it’s best to rule it out. Likewise, if you’re between 45 and 75, you should undergo routine screening for cancer regardless of your family history. 

Other factors that may increase your risk of developing colorectal cancer include:

  • Having Crohn’s disease, ulcerative colitis, or another inflammatory bowel diseases

  • Leading a sedentary lifestyle

  • Not eating enough fruits, vegetables, and fiber

  • Eating too much fat or too many processed meats

  • Being overweight

  • Drinking too much alcohol

  • Smoking

  • Being of advanced age (the majority of colorectal cancer is diagnosed in people 50 or over)

Risk factors for other gastrointestinal cancers

Like the associated symptoms, the risk factors for gastrointestinal cancers depend on the location. Risk factors may include: 

  • Being 55 or older

  • Being a man

  • H. Pylori infection (the leading cause of GERD)

  • Having pernicious anemia (when the body lacks B12 and can’t make enough red blood cells)

  • Having undergone stomach surgery

  • Having a hepatitis B or hepatitis C infection

  • Having alcohol-related liver disease

  • Having hemochromatosis (a condition in which the body stores too much iron)

  • Smoking

  • Drinking too much alcohol

  • Having a family history of gastrointestinal cancers

  • Low SES (socioeconomic status)

  • High-temperature beverages & foods

Your race may also be a risk factor for certain gastrointestinal cancers. In their analysis of data from the National Cancer Institute Surveillance, Epidemiology, and End Results Cancer Registry and the National Center for Health Statistics, one team of researchers identified differences in cancer rates among different racial groups.³

In particular, the researchers found that:

  • People of Asian or Pacific Islander descent had the highest rates of gastric cancer and the lowest rates of esophageal cancer

  • Hispanic people had neither the highest nor the lowest rates of any type of gastrointestinal cancer but were most commonly affected by liver and gastric cancers

  • People of American Indian or Alaska Native descent were disproportionately affected by liver cancer

  • Non-Hispanic Black people had the highest rates of pancreatic and colorectal cancer

  • Non-Hispanic White people had higher rates of esophageal cancer than all other groups

Risk factors for lymphoma

Researchers don’t know what causes lymphoma, but certain people have a higher risk of developing the condition. Risk factors include:

  • Human immunodeficiency virus (HIV), hepatitis C virus infection, HTLV-1 infection, HHV-8 infection

  • Jewish ancestry

  • Younger adults from higher SES (Hodgkin Lymphoma)

  • Older age (non-Hodgkin Lymphoma) Male sex (non-Hodgkin lymphoma)

  • History of Epstein-Barr virus infection

  • Have a family history of the condition

  • Are over-exposed to certain ingredients in herbicides and pesticides, particularly in farmers

Treatment options for bowel leakage

To effectively treat your bowel leakage, you’ll need to determine the cause. If your incontinence is occasional and doesn’t last long, the solution may be as simple as avoiding certain foods. However, bowel leakage linked to an underlying illness may be more difficult to treat and will require gaining control of the underlying cause. 

While working on identifying and treating the underlying cause, or if correcting the cause is difficult or impossible, the following treatments may help with your bowel leakage: 

Bowel training

This sounds like you're going back to being a toddler, but bowel training or retraining is used to treat both fecal incontinence and severe constipation. A bowel training program typically utilizes several different methods across several weeks to improve bowel habits. These may include encouraging bowel movement after meals using the gastrocolic reflex, encouraging a squatting position to help avoid straining, and following a specific diet.

Pelvic floor exercises can be valuable if leakage is linked to muscle weakness. These exercises are designed to help tone the pelvic and rectal muscles and strengthen them after damage.

Some people may benefit from biofeedback, which involves using a special rectal plug connected to a computer monitor and a monitoring electrode. This gives people a higher level of awareness of what they are doing with their rectal muscles and allows them to exercise them consciously to improve strength and tone.

Over-the-counter medicines

Depending on the cause and other symptoms you may be experiencing, your doctor might recommend over-the-counter medicines. These vary depending on whether you are prone to diarrhea or constipation.

For diarrhea, doctors usually recommend loperamide, codeine sulfate, or amitriptyline. Loperamide is typically used to control acute diarrhea. Your doctor may recommend it for travelers' diarrhea or stomach flu. It slows down bowel movements and improves anal sphincter tone.

Always take medications as directed, and never take more (or less). In some cases, your doctor may prescribe stronger forms than those available over the counter.

For constipation, your doctor may recommend a laxative, a stool softener, or a concentrated fiber supplement such as psyllium. Psyllium can hinder your body’s ability to absorb other medications, so you’ll need to take it two hours before or after other treatments.

Consult your doctor before taking medications to help with your bowel leakage, even over-the-counter ones. Some may worsen your symptoms, and some may mask symptoms of a serious underlying condition that demands medical attention.

Dietary changes

Digestive troubles, including incontinence, may be caused or aggravated by your diet. If your problems are chronic, your doctor may refer you to a nutritionist to develop a personalized diet plan to help you deal with your bowel issues and improve your overall health.

You should keep a food diary, as disruptive foods can vary from person to person. Keep track of what you eat and how it makes you feel. 

If you have constipation or hemorrhoids, your doctor may recommend increasing your fiber and fluid consumption. This might mean switching to whole wheat bread, brown rice, high-fiber cereal, and so on.

If you have diarrhea, you should be cautious with alcohol, caffeine, dairy, spicy foods, sugar alcohols (sometimes used as artificial sweeteners and typically ending in “-ol”), and foods with high levels of fructose.

If your bowel incontinence is triggered by a specific food, your doctor may perform an allergy test to find out which ingredient is causing problems. 

Wearing absorbent pads

Not all causes of bowel incontinence are treatable, and those that are treatable typically require some time to improve. Your doctor will almost certainly recommend that you wear absorbent pads, which can drastically improve your quality of life.

Modern absorbent pads are well-designed and discreet, and it’s unlikely anyone will notice that you’re wearing them. They might be a long-term solution or a temporary one while other treatments have time to work or while you determine which foods might be causing or aggravating your symptoms.

When to see a doctor

You should always see a doctor if you have symptoms of bowel incontinence. In some cases, it can be a sign of something more serious, including bowel cancer. However, it is relatively rare for bowel incontinence to be a sign of cancer. It is more likely related to a less severe, treatable condition.

You may be hesitant to see your doctor about bowel leakage, but remember, doctors and medical professionals have heard and seen it all. Seeing a doctor is essential to rule out serious conditions that may get worse with time or lead to severe complications.

The lowdown

Bowel leakage is rarely a sign of cancer. In cases where bowel leakage is caused by a condition such as irritable bowel syndrome or muscle weakness, gaining control of the underlying condition can help improve bowel control. Strengthening exercises and medications can help reduce the frequency of bowel leakage, and absorbent pads can make the condition less disruptive. 

While bowel leakage can be embarrassing, it’s a common condition. Most causes aren’t serious, but it’s essential to see a doctor to pin down the cause and determine the appropriate treatments.

  1. Risk of cancer in patients with fecal incontinence (2019)

  2. Colorectal cancer risk factors | American Cancer Society

  3. Racial and ethnic disparities in incidence and mortality for the five most common gastrointestinal cancers in the United States (2022)

Other sources:

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